One of the significant concerns for a woman taking contraceptives is the effects of contraceptives on their reproductive system and ability to conceive in the future. On global basis, a contraceptive decreases the risk of unwanted pregnancies and unsafe abortions, which may compromise a woman’s future fertility.
Combined oral contraceptive pill is one of the most popular methods of contraception. Around 70% of users of oral contraceptive pill are in the age group of 20-30, therefore effect on future fertility is a major concern for them. After stopping combined contraceptive pills, return of ovulation is prompt and woman should be aware of this if she is not planning for pregnancy. Use of oral contraceptives has beneficial effects on future fertility. Because of protestrogenic action on cervical mucus, pills decrease the risk of ascending infections and PID. There is no increased risk of pregnancy loss or ectopic pregnancy after discontinuation of pills. According to studies 70% of women ovulated in the first cycle and 98% by the third cycle after discontinuation of pills. So women taking combined oral contraceptive (OC) pills can be reassured that these pills do not affect future fertility.
Injectable Contraceptives: Depot provera, a progesterone injection is given intramuscularly once every three months. It is not intended for women who want to plan pregnancy any time soon. It is a highly effective method of contraception but it can have lingering effects on fertility. It is present in your body for many months because it is deposited in the muscle. Median time for return to fertility is 10 months after the last injection though pregnancy can occur as early as 3 months.
Intrauterine Devices: IUD is a reliable and extremely effective method of reversible contraception. However there are concerns about its associated risk of pelvic infection and salpingetis, so careful selection of patient is very important ensuring that women who are at increased risk of pelvic infection are not offered IUD as first choice of contraception. When IUD’s are given to appropriate patients risks of infection is extremely low, only a slight increased risk of infection during the first few weeks after insertion. When IUD is removed, the return of fertility is fairly rapid.
Barrier Method: Barrier method such as male or female condoms reduces the risk of sexually transmitted infections. Therefore fertility rates are likely to be enhanced with the use of barriers.
So in conclusion with all reversible method of contraception there is very little evidence that fertility is impaired after contraceptive use. Contraception frees woman from the risk of pregnancy, abortion. Careful selection of the appropriate contraceptive method for each woman will allow her reproductive carrier to be preserved.